title: Safety assessment of intravenous administration of trastuzumab in 100ml saline for the treatment of HER2- positive breast cancer patients.
abstract: BACKGROUND
  The infusion rate is considered to affect incidence and severity of infusion reactions (IRs) caused by protein formulations. Trastuzumab (TRS) is approved for 90-minute infusion as the initial dose followed by 30-minute infusion with 250 ml saline. In the study, we evaluated the safety of TRS intravenously administered over 30 minutes with 100 ml saline to reduce burden of patients, safety of infusion with 250 ml saline already being established.
  
  
  METHODS
  Women with HER2 positive breast cancer, ≥18 years and ≥55% left ventricular ejection fraction (LVEF), were registered in the study. Patients received 8mg/kg of TRS 250 ml over 90 minutes followed by 6mg/kg of TRS 100ml over 30 minutes in a three-week cycle.
  
  
  RESULTS
  A total of 31 patients were recruited, 24 for adjuvant therapy and seven with metastases. The median age was 59 years (range 39 to 82). The total number of TRS doses ranged from 5 to 17 with the median of 15. Mild IR occurred in two patients at the first dose. However, no IR was observed after reducing to 100 ml saline. No decrease of LVEF, increase of serum brain natriuretic peptide or any other adverse events were reported.
  
  
  CONCLUSIONS
  Intravenous infusion of TRS with 100 ml saline over 30 minutes in breast cancer patients can be considered safe based on results from the study. It can be given on an outpatient basis as with the currently recommended dilution in 250 ml saline.
authors.affiliation: Breast Center, Bell Land General Hospital, Osaka, Japan E-mail : abe@belle.shiga-med.ac.jp.
authors.forename: Hajime
authors.initials: H
authors.lastname: Abe
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Mori
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kawai
authors.forename: Kaori
authors.initials: K
authors.lastname: Tomida
authors.forename: Keiichi
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kubota
authors.forename: Tomoko
authors.initials: T
authors.lastname: Umeda
authors.forename: Tohru
authors.initials: T
authors.lastname: Tani
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D012449:Safety; D000068878:Trastuzumab; D016277:Ventricular Function, Left
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D020097:Natriuretic Peptide, Brain; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human